Florida State Paramedic Practice Exam

What is the preferred site for central line cannulation?

1. Internal jugular

2. Femoral

3. Subclavian

4. External jugular

The correct answer is: External jugular

The preferred site for central line cannulation often depends on various considerations, including the patient's anatomy, clinical condition, and the provider's experience. The internal jugular and subclavian veins are commonly used, with the internal jugular being frequently favored in emergency settings due to its accessibility and the angle of entry that reduces the risk of pneumothorax. The external jugular vein, while technically not the most conventional choice in critical care settings, can offer a viable option in certain scenarios, especially when the other sites are not accessible or have been previously catheterized. It's also easier to visualize and locate superficially, which can sometimes make insertion simpler. However, it typically provides less reliable long-term access compared to internal jugular or subclavian sites due to its more superficial nature and potential for thrombosis. The femoral site is generally reserved for specific conditions or as a last resort due to its complications and higher infection risk, making it less favorable for routine central line insertions. In summary, while the external jugular can be considered for central line access, understanding the advantages and limitations of each site is crucial for safe and effective catheter placement.